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Design of a Research Study on the influence of the Household Model in nursing homes

Design of a Research Study on the influence of the Household Model in nursing homes. Mark Morgan-Brown Dympna Manley Marcus Ormerod Rita Newton SURFACE Inclusive Design Research Centre University of Salford , England. Presentation Outline. Background context

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Design of a Research Study on the influence of the Household Model in nursing homes

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  1. Design of a Research Study onthe influence of the Household Model in nursing homes Mark Morgan-Brown Dympna Manley Marcus Ormerod Rita Newton SURFACE Inclusive Design Research Centre University of Salford, England

  2. Presentation Outline • Background context • Household Model for nursing homes • Design objectives • Photographs • Research methodology

  3. An Ageing World:2008 U.S. Census Bureau: International Population ReportsKinsella and He (2009) Social Phenomenon without Precedent 2040 World Population ↑160% aged 65+ ↑233% aged 80+

  4. Alzheimer’s Association, 2009 USA Sixth leading cause of death Dementia prevalence age 65 = 1 person in 8 age 85 = 30-45%

  5. Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based survey Sousa, Ferri, Acosta, Albanese, Guerra, et al. The Lancet, 366, 9503, 2112-2117 Dementia is overwhelmingly the most important independent contributor to disability for elderly people in countries with low and middle incomes. Dementia: 25.1% Stroke: 11.4% Limb impairment: 10.5% Arthritis: 9.9% Depression: 8.3% Eyesight: 6.8% Gastrointestinal: 6.5%

  6. UK: RISING TIDE OF DEMENTIA (2031) UK figures as reported in: Comas-Herra, et.al. (2007) International Journal of Geriatric Psychiatry, 22, 1037-1045 0.96% of GDP 88% increase in number of people in care homes

  7. RESIDENTIAL CAREMozley (2001) J of Occ Science Predictors of death (9 months post admission) 1. Barthel Activities of Daily Living 2. Cancer, acute infection, endocrine or cardiovascular disorders 3. Little satisfaction with daily occupations

  8. Doing as much as I can do: The meaning of activity for people with dementiaPhinney, Chaudhury, O’Connor, Aging & Mental Health, 2007, 11(4), 384-393 Community dwelling elders with mild to moderate dementia

  9. Household ComponentsCalkins. (2009) Evidence based long term care design. NeuroRehabilitation 25, 145-154

  10. Household Model Principles Each household is a person’s home The kitchen becomes the focus Residents participate in meal preparation / household activities

  11. Pre-Renovation

  12. Post-Renovation

  13. Pre-Renovation

  14. Post-Renovation

  15. Post-Renovation

  16. Post-renovation

  17. ASSESSMENT TOOL for OCCUPATION & SOCIAL ENGAGEMENT (ATOSE) SEGMENT SEQUENCE NO: SEGMENT START OBS TIME DATE of OBS RESIDENTS VISITORS STAFF Active Social Engagement Social Engagement Social Engagement x R . x R. x R. x V. x V. x V. x S . x S. x S. mixed mixed mixed non-verbal non-verbal non-verbal Welcome Welcome Welcome Activity Activity Activity kit. / dom. - I. kit. / dom. - I. kit. / dom. - I. kit. / dom. - R. kit. / dom. - R. kit. / dom. - R. kit. / dom. - V. kit. / dom. - V. kit. / dom. - V. kit. / dom. - S. kit. / dom. - S. kit. / dom. - S. rec. - I. rec. - I. rec. - I. rec. - R. rec. - R. rec. - R. rec. - V. Rec. - V. rec. - V. rec. - S. rec. - S. rec. - S. rec. group - I. rec. group - I. rec. group - I. rec. group - R. rec. group - R. rec. group - R. rec. group - V. rec. group - V. rec. group - V. rec. group - S. rec. group - S. rec. group - S. Passive Engagement with Surroundings Passive Engagement with Surroundings Passive Engagement with Surroundings non / A. non / A. non / A. Receiving Care Care tasks Care tasks P.care - R. P.care - R. P. Care Prof. care Other Work tasks Passive / Agitated Behaviours Partnership prof. tasks eyes closed meal / snack dom. agitated cater. self-stimulation

  18. Methods Qualitative • Interviews staff and relatives • Interviews senior management Quantitative • Direct snapshot observation • Attitude surveys staff and relatives

  19. The authors thank the Managements of the Moorehall Lodge, Ardee, Co. Louth and Castleross Nursing & Convalescent Centre, Carrickmacross, Co. Monaghan. The authors also wish to acknowledge the Residents, Staff and Visitors who contributed to this research project. Mark Morgan-Brown wishes to thank Homecare Medical Supplies, Ballyhaunis, Co. Mayo for their generous funding, which enabled this AOTI conference presentation.

  20. Mark Brown, Occupational Therapy Specialist in Inclusive Design for People with DementiaCavan, Irelandmark.brown@hse.ie

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